The COVID-19 pandemic sparked a wave of medical advice on social media, increasing health awareness but also causing confusion due to contradictory information and opinions. This constant supply of mixed messages strained the trust between doctors and patients.
Amid this digital shift, my journey into integrative medicine started with a deep dive into meditation and stress reducing practices, which introduced me to the concept of the brain’s Default Mode Network and its role in regulating behavior. This sparked my curiosity regarding how such practices could be measured, leading me to tools like functional MRI and the research behind it. The more I explored, the more fascinated I became by the many ways in which these practices could support neurological health, guiding me further into the world of integrative approaches.
I am currently pursuing a fellowship in integrative medicine through the Academy of Pediatric Integrative Medicine at the University of Arizona — a unique online program tailored for busy physicians. Applying these insights directly to my child neurology clinic has been helpful. For instance, I’ve integrated sleep-supportive modalities such as aromatherapy and tryptophan supplementation when appropriate, ensuring families understand both the benefits and potential risks. Improper use of essential oils can lead to allergic reactions, respiratory symptoms, and even hormonal imbalances in rare cases. Similarly, while tryptophan supplementation may improve sleep, it can also cause side effects like nausea, dizziness, and dry mouth and rarely may contribute to serotonin syndrome when combined with other serotonergic agents.
Dr. Cecilia Fernandes discussing magnesium supplements for the treatment of migraine headaches with her patients in the child neurology clinic.
In managing headaches, I’ve found success combining aromatherapy with anti-inflammatory dietary changes, using visual aids to make these dietary adjustments more accessible and practical for families. Additionally, I’ve introduced biofeedback techniques like box breathing, and I’ve educated families about heart rate variability feedback to help regulate the nervous system.
I take the time to carefully evaluate the safety and appropriateness of supplements, discouraging their use when evidence is lacking or when they pose potential risks. Discussing integrative approaches has enriched my practice, enabling me to offer more comprehensive care while empowering families and building trust in the doctor-patient relationship.
According to the Merck Manual, terms like “complementary,” “alternative,” and “integrative” medicine are often used interchangeably, but each has its own definition. Complementary medicine refers to non-conventional practices used alongside conventional treatments, while alternative medicine replaces conventional treatments with non-conventional ones. Integrative medicine, however, combines both conventional and non-conventional therapeutic approaches, focusing on the whole person, their health, and the therapeutic relationship.
IM stands out because of its emphasis on well-being, rather than just treating symptoms. Concepts like “whole-person care” and “patient-centered care” shift treatment into a collaborative process between doctor and patient. Integrative medicine also includes five main complementary health approaches—Alternative Medical Systems, Mind-Body Interventions, Biologically-Based Therapies, Manipulative and Body-Based Methods, and Energy Therapies—all of which provide holistic support for neurological health. Practices like meditation, acupuncture, and biofeedback are effective in managing conditions like headaches, Parkinson’s disease, and chronic pain. In addition, an anti-inflammatory diet can enhance cognitive function, reduce stress, and promote overall brain health.
The Circle of Health places individuals at the center, recognizing their uniqueness. Through mindful awareness and self-care, they are empowered and supported by a team of professionals using both conventional and complementary methods. Together, they create a Personal Health Plan tailored to what matters most to the individual, with support from their community. Source: va.gov/wholehealthlibrary
One striking example of IM in action is the Whole Health model used in Veteran Affairs (VA) hospitals. This model shifts from disease-centered care to a personalized, patient-driven approach, incorporating practices like mindfulness and acupuncture alongside conventional medical treatments. As a result, veterans benefit from better outcomes in managing chronic pain, PTSD, and other conditions.
For healthcare professionals seeking to train in integrative pediatric medicine, programs like the Stanford Pediatric Integrative Medicine Fellowship, the online Academy of Pediatric Integrative Medicine (APIM) Fellowship, and the Andrew Weil Center for Integrative Medicine at the University of Arizona offer rigorous training in evidence-based integrative practices. These programs emphasize the critical need to understand the safety and efficacy of complementary therapies, ensuring their thoughtful and responsible incorporation into clinical practice.
In a rapidly evolving healthcare landscape, integrative medicine offers a patient-centered approach that strengthens trust, cultivates compassion, and optimizes care. By harmonizing scientific rigor with the art of healing, it expands the boundaries of traditional medicine, fostering comprehensive well-being.
EDITOR’S NOTES
As child neurologists, most of us practice “conventional” medicine – medical science that is scientifically strong and evidence-based but that sometimes focuses too much on symptoms and disease. This approach is often criticized for neglecting the person as a whole. “Alternative” medicine takes a different tack by addressing the whole person, but this approach can be criticized for using techniques that are often questionable and unproven. In recent years, a third option has emerged – “integrative” medicine. This third model seeks to meld the best conventional and alternative methods together. I asked Dr. Cecilia Fernandes, an assistant professor of neurology at Wake Forest University in Charlotte, North Carolina, to describe how she learned about Integrative Medicine and has woven it into her practice of child neurology.